Laryngoscopes are well known in the art and are used in intubating the trachea for administration of general anesthesia, during emergency situations in resuscitation and for mechanical ventilation. Endotracheal intubation requires the insertion of a flexible tube through the oral cavity (or sometimes nasal cavity), the oropharynx, the glottis and into the trachea. Safe and successful intubation requires controlled insertion of the endotracheal tube so that the tube is introduced through the glottis of the larynx without damaging the teeth or surrounding tissues such as oropharynx, epiglottis, vocal cords or laryngeal cartilages. It is desirable that the practitioner inserting the tube have as clear a view as possible of the glottis and vocal cords to guide the tube into the trachea successfully and without injury to the patient.
Frequently it is difficult or even not possible to obtain a clear view of the glottis, so it is desirable that optimal positioning of the laryngoscope blade and the patient's head be attained for increasing the success of endotracheal intubation.
A laryngoscope has a handle and a blade. The laryngoscope blade is used, when inserted properly, to lift the tongue and frequently lift the head upward to create a clear path through the glottis into the trachea. Laryngoscopes have a light source for illuminating the mouth, oropharynx and glottis to enhance accurate placement of the laryngoscope blade and insertion of the endotracheal tube.
The intubation process typically requires extending the head of the patient to facilitate insertion of the laryngoscope blade into the mouth. With the laryngoscope blade in place against the tongue of the patient, the practitioner uses the laryngoscope to lift the tongue and frequently lift the patient's head with the blade to expose the glottis into view.
There are several problems with the conventional manner in which endotracheal intubation is performed. Because the blade is used to lift and position the patient's head, there is a certain likelihood of trauma to the soft tissues of the patient's mouth, pharynx, vocal cords, laryngeal cartilages and to the teeth, leading to bleeding, sore throat, hoarseness or dislodgment or breakage of teeth. Although some endotracheal intubations are simple and require little raising and manipulation of the head, even in routine non-difficult intubations, some blood is frequently noted on removal of the endotracheal tube indicating a degree of trauma to the patient's tissues.
Furthermore, because the practitioner typically uses his/her weaker non-dominant hand to hold the laryngoscope handle and insert the laryngoscope blade so that the dominant hand can be used to insert the endotracheal tube, the practitioner often has difficulty lifting, supporting and manipulating the patient's head, particularly a very heavy head, with the weaker non-dominant arm and hand. This is particularly a problem in practitioners with weaker arms and hands. Therefore, in a substantial percentage of cases, the practitioner is required to request and wait for another person's, typically a nurse's, assistance in lifting the patient's head into optimal position. This person also frequently is asked to apply pressure on the front part of the neck over the cricoid cartilage for better visualization of the glottis and to prevent aspiration of gastric contents which can cause pneumonia, lung abscesses or even death. The necessity of calling for and requiring an assistant causes delay and interferes with the nurse's performance of his/her tasks in getting the surgical procedure underway.
When an endotracheal intubation cannot be accomplished with just the use of a laryngoscope, other methods such as those using special laryngoscopic equipment and/or intubating bronchoscopes must be used. However, the use of these other methods requires additional time, thereby delaying the initiation of the surgical, diagnostic or medical procedure, increasing the possibility of causing hypoxia to the patient and increasing the patient's cost.